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The recent articles by Fisher and colleagues (1, 2) highlighting the implications of regional variations in Medicare spending have added to our understanding of the importance of effective medical spending. The authors should be applauded for challenging the general assumption that additional spending on health services will necessarily provide important health benefits.

It is interesting to note that these findings seem to complement a Canadian study by Zelder (3), which found that regions with higher overall government health spending per capita had no effect on reducing patient waiting times. However, the Zelder study did note that the only direct correlation between increased funds and reduced waiting times comes from money spent to subsidize drugs, leading to fewer hospital visits and less congested waiting rooms. In addition, Michaud and colleagues (4) acknowledged that a challenge to the future of medicine is to allocate resources effectively to reduce the major causes of disease burden globally.